Chronic heavy drinking isn’t good for you, nor is regular binge drinking. For your health (and happiness?) if you drink too much you should consider quitting entirely.
OK, but what do you do if you can’t quit or you just don’t want to quit right now? Does it have to be all or nothing? Are drinking less per session, drinking less frequently or minimizing the harms associated with drinking also reasonable goals for health and well-being promotion?
Well, according to the principles of harm reduction, there is a middle ground that doesn’t demand complete abstinence and that lets you develop a workable plan to reduce the harms associated with drinking, while you still continue to drink.
We often think of harm reduction initiatives as community-wide projects that target people with the most serious drug and alcohol problems, however, you can just as easily apply the principles of harm reduction to your own life and take active steps to reduce the negative consequences of your substance use.
Individual harm reduction measures can improve your health and quality of life. These measures are most appropriate for people:
- Who cannot or do not want to stop completely but wish to use less (possibly with a goal of eventually stopping completely) or drink with fewer adverse consequences.
- Who do not want to cut down but want to reduce associated harms.
Considering Harm Reduction
When considering a program of harm reduction it’s useful to take stock and think about what you’d like to change most and about what current behaviors cause you the greatest harms or risks of serious harms.
- Is your health at immediate risk?
- Are hangovers interfering with your performance at work or school?
- Do you have a problem with drinking and driving?
Next, think about some changes you could live with that might reduce or eliminate some or all of your most serious concerns?
- One useful tool you might consider to help with this process is called The Drinker’s Checkup. This is a free online questionnaire tool that helps outline what changes you might want to make.
- You might also want to try a decisional balancing exercise,
which helps you delineate exactly what you like and don’t like about your
- Or, ask yourself about your ‘ideal use situation’. If you could use alcohol in any way, what way would provide you the most pleasure/positive effects with the least pain/negative effects. Once you identify your ideal use situation, adopt harm reduction strategies to take you progressively closer to it.1
Make Specific Goals
As a general rule, it’s helpful to set clear goals. Whatever you decide to do, make it specific and measurable – and then keep close track of your drinking to evaluate how well you stick to your plan. For example:
- Don’t just plan to ‘cut down your drinking’, plan to cut down from an average of 8 drinks a day to an average of 5 drinks a day. Or, plan to cut down from 7 days of drinking per week, to 6 and then 5 within a set period of time.
You can keep track quite easily via a number of free or low cost apps for your phone or tablet.
A Collection of Individual Harm Reduction Ideas
Here is a collection of ideas that may help you moderate your drinking or reduce the harms that are associated with your drinking.
Stay Home and Stay Safe
If you plan to get drunk, stay at home. By staying safely at home you avoid many possible negative consequences and dangers associated with public intoxication.2
Don’t pre-drink (preload) before social events, before going out for the night or to places where alcohol is more expensive or less available.
In one study, English young adults who preloaded were 2.5 times more likely to get into a drunken fight than young adults who drank only once out for the night. Other studies have found that preloading leads to greater negative outcomes and higher overall consumption.3
Watch Your Vitamins
If you drink more than a few drinks daily then you are likely vitamin-deficient. Take extra supplementary vitamins and/or ensure that your diet makes up for the losses. According to the National Institute of Health, between 30% and 80% of heavy drinkers are thiamine deficient, and this can lead to Wernicke’s Encephalopathy and Korsakov’s Syndrome. If you are very deficient, you can’t always get enough absorption via oral ingestion and you’ll need to talk to your doctor about a thiamine injection. It’s a largely side-effect free intervention that could save your health or even your life.4
Drink Less per Session
You can reduce the health consequences of excessive drinking by consuming less alcohol in each drinking session, such as by:
- Alternating between alcoholic and non-alcoholic drinks.
- Switching to lower-alcohol drinks, such as from regular strength beer to light beer.
- Waiting until later in the day than normal to have your first drink (plus avoiding pre-drinking before going out).
- If you drink at home, buy just enough for your session and keep no additional alcohol at home.
- Foregoing the hair of the dog hangover cure.
You will likely need to have a concrete plan for your reductions, especially considering how intoxication erodes will-power and judgment.
Research demonstrates that people who follow harm reduction programs can effectively reduce consumption and alcohol-related problems.5 If you find that a solo harm reduction program isn’t workable, consider getting involved with a group of like-minded individuals such as through HAMS Harm Reduction for Alcohol or Moderation Management.
Take One or More Days Off
As an alternative to reducing the amount you drink per session, you could instead (or also) reduce your weekly drinking days.
Taking days off cuts down your total weekly drinking, gives your body time to recover between sessions and lets you plan your drinking so you can take a day or days off before important work or school commitments.
- If you’ve been drinking daily for a while, you should talk to your doctor about your readiness for a full day of abstinence. In some cases, people with serious alcohol dependencies can experience dangerous withdrawal symptoms when trying for sudden abstinence.
- You should expect cravings and temptation – taking a day off isn’t easy, especially for people with a long habit of daily drinking. Plan enjoyable no-alcohol activities to help keep your mind off alcohol, and plan for how you'll deal with the cravings you’ll likely experience.
Taking a day or days off is hard at first, but it gets much easier with practice.
The rewards of reduced drinking accumulate slowly, but the pleasures of a drink arrive immediately, and when you’re trying to cut-down, this pleasure-delay makes things difficult.
To circumvent our natural human preference for immediate gratification, use the principles of contingency management and reward yourself for your successes with small treats or self-gifts (use the money you’d have spent on drinking on something fun for yourself).6
If You Go Out, Arrange in Advance for Safe Transport Home
Plan for how you’ll get home before you go out drinking. If drinking and driving is a problem for you, take steps before you have your first drink to reduce the odds that you’ll be in a position to drive. Walk, take public transport or travel with a designated driver. If you tend to reach for the keys at home once drunk, have someone else hold them for you or keep them off site in a location you can’t easily access.
Consider Drug Substitution
Some people find harm reduction success by switching from alcohol to marijuana on some or all drinking occasions. You will have to evaluate for yourself any potential legal or other risks associated with this harm reduction method.
Eat before You Start Drinking
Food in your belly helps delay the rush of alcohol into your bloodstream and keeps you from getting too drunk too fast.
Continue to eat slowly as you drink - and also consume hydrating fluids while drinking alcohol to prevent excessive dehydration.
Also, try to avoid drinking when you’re feeling tired or run-down.
Pour and Measure Your Own Drinks
It’s hard to keep tight control over your drinking (and therefore stick to your drinking goals) unless you pour your own drinks and measure each one carefully.7
If you plan to only drink on certain days or only certain amounts on any given day, don’t allow your emotional state to alter your good intentioned-plan.
- Use alcohol when you’re angry or upset and you’re likely to drink too much and derail your good efforts.
- Some harm reduction therapists go so far as to recommend a brief period of mindfulness prior to drinking, as a way to get in touch with your current emotional state and to make sure that your drinking won’t exacerbate a negative head-space.8
Change in Incremental Steps
Remember, change doesn’t have to happen as a sudden 180 degree turn. Rather than thinking of change as an all or nothing phenomenon, it’s entirely reasonable to work through manageable small steps of progress – after all, as the saying goes, the longest of journeys begins with a single step.
If you want to improve your health and well-being, but you don’t feel ready or able to quit entirely, maybe you should consider taking small steps of harm reduction today.
Page last updated Nov 24, 2015